Ep. 265 Managing Ischemic Priapism: Surgical Approaches & Outcomes with Dr. Maia VanDyke

For patients with ischemic priapism, time to treatment can mean the difference between recovery and long-term dysfunction. In this episode, Dr. Maia VanDyke (UT Southwestern Medical Center) joins host Dr. Juan Andino (UCLA Health) for a high-yield discussion on managing this urologic emergency, from early recognition to advanced surgical options.---SYNPOSISTogether, they cover diagnosis, patient demographics, and traditional versus advanced interventions, with special attention to the role of penoscrotal decompression in prolonged ischemic priapism. The conversation highlights surgical techniques, postoperative care strategies, and patient counseling, including the hard but essential discussions about long-term erectile dysfunction risk. Drs. Andino and VanDyke also emphasize the importance of collaboration, encouraging general urologists to adopt these approaches while leaning on colleagues and centers of excellence for complex cases.---TIMESTAMPS00:00 - Introduction02:18 - Understanding Priapism07:52 - Diagnosis and Initial Management16:51 - Advanced Management and Surgical Interventions28:21 - Patient Retention Challenges29:59 - Surgical Planning and Techniques37:29 - Post-Operative Care and Patient Rehabilitation44:13 - Future Directions in Research and Treatment51:28 - The Role of General Urology---RESOURCESDr. David Ralph article on use of MRI in management of priapismhttps://doi.org/10.1111/j.1464-410X.2010.09368.xDr. Tom Lue article on corporal aspirationhttps://doi.org/10.1038/nrurol.2009.50Arthur “Bud” Burnett article on corporal tunnelinghttps://doi.org/10.1016/j.juro.2012.08.245Allen “Al” Morey article on penoscrotal decompression erectile function outcomeshttps://doi.org/10.1111/bju.15127Survey on current management practices of ischemic priapismhttps://doi.org/10.1038/s41443-019-0120-4Risk factors, diagnosis, and long-term erectile dysfunction outcomes in priapismhttps://doi.org/10.1038/s41443-025-01076-9Video Journal of Sexual Medicine (VJSM) on Penoscrotal decompression: A better method for priapism managementhttps://www.vjsm.info/videos/all/penoscrotal-decompression-a-better-method-for-priapism-managementSurgical Management of Ischemic Priapism: what are the New Options? https://doi.org/10.1590/S1677-5538.IBJU.2024.0497The Impact of Immediate Salvage Surgery on Corporeal Length Preservationhttps://doi.org/10.1016/j.juro.2018.01.082